Jews and Hereditary Cancer
Cancer occurs when the normal mechanisms that control cell growth are not working properly. This can happen when genes themselves are damaged, due to changes called mutations. When mutations occur in the damage-controlling genes, cells can grow out of control and cause cancer.
Mutations can be acquired or inherited. Acquired mutations can be caused by a variety of environmental factors, such UV exposure, radiation, chemicals, viral infection, or random events. For most people who develop cancer, the cancer-causing gene mutations are acquired mutations that happen over the
course of a lifetime, leading to cancer later in life.
This video explains how cancer cells behave differently than normal cells:
This video talks about how cancer spreads through the body:
This is a short overview of cancer and available treatments:
What Is Hereditary Cancer? How Does It Differ From Sporadic Cancer?
- Individuals born with a gene mutation that they inherited from their mother or father puts them at higher risk for cancer than most people. When cancer occurs because of an inherited gene mutation, it is referred to as "hereditary cancer."
- Hereditary cancers account for 5-10% of all cancers. They result from inherited cancer-causing mutations in genes passed down generation to generation which, when combined with acquired mutations, significantly increase an individual’s risk to develop cancer above the rate of
the general population. For sporadic cancer, the individual’s cells have acquired mutations that disrupt the normal function of one or more genes, causing the cells to grow out of control. These mutations happen randomly and are not passed through the families. These individuals do not have inherited
What is Your Risk for Hereditary Cancer?
It is impossible to tell from family history alone whether or not you are at risk for hereditary cancer. However, there are factors that tend to be found more often in hereditary cancers, and may lead an individual to seek genetic counseling and, if appropriate, screening.
- Two or more closely related individuals with breast cancer, diagnosed at any age
- Cancer diagnosed at young ages (before 50)
- Multiple cancer diagnoses in one individual (i.e. breast and ovarian, bilateral breast cancer)
- Individuals affected in multiple generations (i.e. grandfather, mother and aunt)
- Rare cancers such as ovarian cancer or male breast cancer
- Two or more family members with breast, ovarian, pancreatic, prostate, skin, uterine, colon or stomach cancers
- Ashkenazi Jewish ancestry
If you one or more features listed above fits your family history, you could be at increased risk for a hereditary cancer. Genetic counseling services can help you further assess your risk and decide whether or not to get screened. Not sure where to go? The Center for Jewish Genetics can help you get started.
This CDC video tells one story of an Ashkenazi woman whose journey was shaped by her family health history:
Facts About Breast & Ovarian Cancer:
- Approximately 5-10% of breast cancer and 15% of ovarian cancer is hereditary. The two genes that cause the vast majority of hereditary breast and ovarian cancer are called BRCA1 and BRCA2. These are tumor suppressor genes that normally control cell growth and cell death. We all carry these genes, but people who carry mutated forms of the BRCA1 and BRCA2 genes have a predisposition to certain types of cancer. Women and men who carry a mutation, regardless of whether they develop cancer, have a 50% chance of passing the mutation on to the next generation. This is called autosomal dominant inheritance.
- Approximately 1 in 40 individuals of Ashkenazi Jewish descent carries a BRCA mutation. Individuals who carry a BRCA1 or BRCA2mutation or those with a strong family history are considered “high risk.” The Ashkenazi carrier rate is 10 times higher than for the general population.
- In addition to breast cancer, BRCA1 and BRCA2 mutations also increase the risk of ovarian cancer, prostate cancer, pancreatic cancer and melanoma. Cancers in people with hereditary risk tend to develop at younger ages (50 years) compared to cancers in the general population, although they may develop at any age. genetic testing can help individuals be proactive about their risk and learn how to prevent and detect cancer at earlier stages.
Surveillance and management for BRCA1 and BRCA2 mutation carriers:
Active surveillance and management, as well as lifestyle modifications, can significantly decrease one’s risk. Your personal health and family history will help determine at what age and how frequently to utilize these strategies. Please consult your physician for individual recommendations.
General Recommendations May Include:
- Breast self-exams
- Clinical breast exams and pelvic exams
- Breast MRI, which can detect early breast cancers that are undetected on a mammogram and not felt by a physician
- Transvaginal ultrasound and CA-125 blood serum level, to screen for ovarian cancer (note: this screening has limitations and can miss cancers during the early, most curable stages)
- Chemoprevention medications such as tamoxifen, to help prevent breast cancer, and oral contraceptives, to help prevent ovarian cancer
- Preventive breast surgery, along with a discussion of breast reconstruction
- Preventive removal of the ovaries and fallopian tubes, along with a discussion of hormonal and non-hormonal management of menopausal symptoms and prevention of bone loss
General Risk Reduction Strategies Include:
- Maintaining a healthy diet high in fruits and vegetables and low in fat
- Decreasing alcohol consumption and avoiding nicotine
- Exercising regularly; your risk of breast cancer may be up to one-third lower with regular physical activity
- Childbearing, tubal ligation (“having your tubes tied”) and the use of oral contraceptives have all been identified as possible protective factors against ovarian cancer (note: these are not as effective as preventive surgery). Breastfeeding is also a possible protective factor against both
breast and ovarian cancer.